• 제목/요약/키워드: Spinal Cord Compression

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Effect of Tetramethylpyrazine on Neuronal Apoptosis in Spinal Cord Compression Injury of Rats (Tetramethylpyrazine이 흰쥐 척수압박손상의 신경세포 자연사에 미치는 영향)

  • Jo, Jong-Jin;Kim, Seung-Hwan;Lee, Joon-Seok;Shin, Jung-Won;Kim, Seong-Joon;Sohn, Nak-Won
    • Journal of Korean Medicine Rehabilitation
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    • v.23 no.1
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    • pp.1-13
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    • 2013
  • Objectives : The pathophysiology of acute spinal cord injury(SCI) may be divided into primary and secondary mechanisms of injury. The secondary mechanism involves free radical formation, excitotoxicity, inflammation and apoptotic cell death, and sets in minutes after injury and lasts for weeks or months. During this phase the spinal tissue damages are aggravated. Therefore, secondary mechanisms of injury serve as a target for the development of neuroprotective drug against SCI. The present study investigated the effect of tetramethylpyrazine(TMP), an active ingredient purified from the rhizome of Ligusticum wallichii(川芎, chuanxiong), on neuronal apoptosis in spinal cord compression injury in rats. Methods : SCI was subjected to rats by a static compression method(35 g weight, 5 mins) and TMP was treated 3 times(30 mg/kg, i.p.) during 48 hours after the SCI. Results : TMP ameliorated the tissue damage in peri-lesion of SCI and reduced TUNEL-labeled cells both in gray matter and in white matter significantly. TMP also attenuated Bax-expressed motor neurons in the ventral horn and preserved Bcl-2-expressed motor neurons. Conclusions : These results indicate that TMP plays a protective role in apoptotic cell death of neurons and oligodendrocytes in spinal cord injury. Moreover, it is suggested that TMP and TMP-containing chuanxiong may potentially delay or protect the secondary spinal injury.

Septated Extradural Arachnoid Cyst in Thoracolumbar Spine Causing Myelopathy

  • Chae, Ki-Hwan;Kim, Seok-Won;Shin, Ho
    • Journal of Korean Neurosurgical Society
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    • v.40 no.5
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    • pp.381-383
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    • 2006
  • Spinal extradural arachnoid cyst is uncommon and rarely cause neural compression. We report a rare case of severe cord compression due to septated spinal extradural arachnoid cyst. A 35-year-old woman has developed back pain 3 months prior to her visit, but recently motor weakness and urinary incontinence occurred. Magnetic resonance images showed an extradural cyst posterior to the cord, which was flattened and displaced from T12 to L2. Urgent decompressive laminectomy and cyst removal was performed. Histopathological examination confirmed that cyst wall was formed by nonspecific fibrous connective tissue without a single-cell layer of inner arachnoid lining. Motor weakness and voiding difficulty were recovered completely after operation.

Surgical treatment of spinal cord compression in client owned dogs with different grades of neurological dysfunction

  • Kuricova, Maria;Ledecky, Valent;Liptak, Tomas
    • Korean Journal of Veterinary Research
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    • v.56 no.2
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    • pp.113-116
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    • 2016
  • Our retrospective study reports the clinical findings and population characteristics of 81 surgically treated dogs for spinal cord compression. We compared the outcome of dogs with different grades of neurological dysfunction due to spinal cord compression and focused on the long-term outcome of surgical treatment, for which there are only a few recent records. We recorded a 13.6% recurrence, regardless of the degree of dysfunction. However, the degree of dysfunction negatively affected the recovery length.

An Unusual Cervical Spinal Meningioma in a Child

  • Cho, Hyok-Rae;Lee, Jong-Koo;Paik, Ae-Lan;Jang, Woo-Young
    • Journal of Korean Neurosurgical Society
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    • v.53 no.2
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    • pp.129-131
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    • 2013
  • The incidence of spinal meningioma is very rare in children. A 14-year-old girl presented with right arm weakness, gait disturbance, and urinary incontinence. Cervical magnetic resonance imaging revealed an intradural extramedullary tumor dorsal to the spinal cord in the level of C1. The tumor was totally removed despite the severe cord compression. Meningotheliomatous meningioma was diagnosed after histological examination.

Effects of Tumor Necrosis Factor Alpha Blocker Adalimumab in Experimental Spinal Cord Injury

  • Borcek, Alp Ozgun;Civi, Soner;Ocal, Ozgur;Gulbahar, Ozlem
    • Journal of Korean Neurosurgical Society
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    • v.57 no.2
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    • pp.73-76
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    • 2015
  • Objective : Tumor necrosis factor alpha (TNF-${\alpha}$) have proven effects in pathogenesis of neuroinflammation after spinal cord injury (SCI). Current study is designed to evaluate the effects of an anti-TNF-${\alpha}$ agent, adalimumab, on spinal cord clip compression injury in rats. Methods : Thirty two male adult Wistar rats were divided into four groups (sham, trauma, infliximab, and adalimumab groups) and SCI was introduced using an aneurysm clip. Animals in treatment groups received 5 mg/kg subcutaneous adalimumab and infliximab right after the trauma. Malondialdehyde (MDA) levels were studied in traumatized spinal cord tissues 72 hours after the injury as a marker of lipid peroxidation. Results : Animals that received anti-TNF-${\alpha}$ agents are found to have significantly decreased MDA levels. MDA levels were significantly different between the trauma and infliximab groups (p<0.01) and trauma and adalimumab groups (p=0.022). There was no significant difference in neurological evaluation of the rats using Tarlov scale. Conclusion : These results suggest that, like infliximab, adalimumab has favorable effects on lipid peroxidation induced by spinal cord trauma in rats.

Retroperitoneal Spinal Extradural Arachnoid Cyst Combined with Congenital Hemivertebrae

  • Park, Se-Hwan;Kuh, Sung-Uk;Lim, Beom Jin
    • Journal of Korean Neurosurgical Society
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    • v.52 no.3
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    • pp.257-260
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    • 2012
  • Spinal extradural arachnoid cysts usually cause symptoms related to spinal cord or nerve root compression. Here, we report an atypical presentation of a spinal extradural arachnoid cyst combined with congenital hemivertebra which was presented as a retroperitoneal mass that exerted mass effects to the abdominal organs. On image studies, the communication between the cystic pedicle and the spinal arachnoid space was indistinct. Based on our experience and the literature of the pathogenesis, we planned anterior approach for removal of the arachnoid cyst in order to focus on mass removal rather than ligation of the fistulous channel. In our estimation this was feasible considering radiologic findings and also essential for the symptom relief. The cyst was totally removed with the clogged 'thecal sac-side' end of the cystic pedicle. The patient was free of abdominal discomfort by one month after the surgery.

Primary Non-Hodgkin's Lymphomas Presenting with Extradural Spinal Cord Compression as the Initial Manifestation (초기 증상으로 척수 압박 증세를 보인 원발성 Non-Hodgkin 임파종)

  • Kim, Se Hoon;Lim, Dong Jun;Cho, Tai Hyoung;Park, Jung Yul;Chung, Yong Gu;Lee, Hoon Kap;Lee, Ki Chan;Suh, Jung Keun
    • Journal of Korean Neurosurgical Society
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    • v.29 no.10
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    • pp.1365-1371
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    • 2000
  • Objectives : Spinal cord compression is a rare presentation of non-Hodgkin's lymphoma(NHL), occurring in 0.1% to 10.2% of patients. Primary spinal extradural NHL, i.e. occurring in the absence of any detectable extraspinal lymphoproliferative disorder, has a potentially favourable outcome if diagnosed and treated early. The authors describe two patients with a clinical picture of acute spinal cord compression as the first presentation of NHL. Methods : The patients were 48-year-old female and 27-year-old female. Both presented with back pain followed by acute paraparesis and voiding difficulty. One patient was diabetic. Plain radiographs of the spine were not specific. Thoracic spine magnetic resonance imaging(MRI) revealed evidence of extradural soft tissue mass extending multiple vertebral segments. Results : The patients underwent emergency laminectomy for decompression and tissue diagnosis. Histological and immunohistochemical study revealed B-cell lymphoma, intermediate grade in both patients. Postoperative staging did not reveal any additional lesions other than extradural manifestation of the malignant lymphoma. Surgery with additional chemotherapy and radiotherapy allowed the clinical improvement of both patients. Conclusion : The authors report two patients with a clinical picture of acute spinal cord compression as the first presentation of NHL, and stress that primary spinal epidural NHL should be a diagnostic consideration in the patient without prior history of malignancy who presents with a prodrome of back pain followed by a rapid neurological deterioration.

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Retroperitoneal Yolk Sac Tumor in Adult Woman Presenting as Spinal Cord Compression and Fatal Pulmonary Tumor Embolism

  • Yi, Hyeong-Joong;Bak, Koang-Hum
    • Journal of Korean Neurosurgical Society
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    • v.39 no.4
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    • pp.296-299
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    • 2006
  • A 35-year-old woman, previously treated for systemic metastases from retroperitoneal yolk sac tumor, presented with progressive painful paraparesis. Preoperative images showed severe cord compression by the metastatic infiltration of the lumbar vertebrae and epidural mass as well as a huge retroperitoneal mass. While performing unremarkable surgery in prone position, the patient abruptly fell into hypoxic insults and circulatory arrest. Intraoperative pulmonary tumor embolism was deemed a cause of death. When planning operative procedure for this dangerous malignancy, scrupulous manipulation is mandated and the possibility of fatal pulmonary tumor embolism should also be addressed and fully discussed preoperatively.

Intensity of Intraoperative Spinal Cord Hyperechogenicity as a Novel Potential Predictive Indicator of Neurological Recovery for Degenerative Cervical Myelopathy

  • Guoliang Chen;Fuxin Wei;Jiachun Li;Liangyu Shi;Wei Zhang;Xianxiang Wang;Zuofeng Xu;Xizhe Liu;Xuenong Zou;Shaoyu Liu
    • Korean Journal of Radiology
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    • v.22 no.7
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    • pp.1163-1171
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    • 2021
  • Objective: To analyze the correlations between intraoperative ultrasound and MRI metrics of the spinal cord in degenerative cervical myelopathy and identify novel potential predictive ultrasonic indicators of neurological recovery for degenerative cervical myelopathy. Materials and Methods: Twenty-two patients who underwent French-door laminoplasty for multilevel degenerative cervical myelopathy were followed up for 12 months. The Japanese Orthopedic Association (JOA) scores were assessed preoperatively and 12 months postoperatively. Maximum spinal cord compression and compression rates were measured and calculated using both intraoperative ultrasound imaging and preoperative T2-weight (T2W) MRI. Signal change rates of the spinal cord on preoperative T2W MRI and gray value ratios of dorsal and ventral spinal cord hyperechogenicity on intraoperative ultrasound imaging were measured and calculated. Correlations between intraoperative ultrasound metrics, MRI metrics, and the recovery rate JOA scores were analyzed using Spearman correlation analysis. Results: The postoperative JOA scores improved significantly, with a mean recovery rate of 65.0 ± 20.3% (p < 0.001). No significant correlations were found between the operative ultrasound metrics and MRI metrics. The gray value ratios of the spinal cord hyperechogenicity was negatively correlated with the recovery rate of JOA scores (ρ = -0.638, p = 0.001), while the ventral and dorsal gray value ratios of spinal cord hyperechogenicity were negatively correlated with the recovery rate of JOA-motor scores (ρ = -0.582, p = 0.004) and JOA-sensory scores (ρ = -0.452, p = 0.035), respectively. The dorsal gray value ratio was significantly higher than the ventral gray value ratio (p < 0.001), while the recovery rate of JOA-motor scores was better than that of JOA-sensory scores at 12 months post-surgery (p = 0.028). Conclusion: For degenerative cervical myelopathy, the correlations between intraoperative ultrasound and preoperative T2W MRI metrics were not significant. Gray value ratios of the spinal cord hyperechogenicity and dorsal and ventral spinal cord hyperechogenicity were significantly correlated with neurological recovery at 12 months postoperatively.